Now that the Supreme Court has spoken and upheld the Affordable Care Act (ACA),
how exactly does this impact state governments?
One of the biggest ramifications of this decision revolves around the ACA’s individual
mandate requiring citizens to purchase some form of health insurance or face a
penalty, and the subsequent requirement for each state to establish a health insurance
While many states have spent the last two years preparing themselves in some
capacity to set up an exchange, the amount of progress made varies greatly from
state to state. Some have taken measureable strides to ensure their exchange is
up and running to meet the October 2013 enrollments and January 2014 coverage
effective deadlines set forth by the ACA, while others have been waiting on the
final decision from the Court. Now that it’s been made, we’re going to see these
states in a scramble to build their HIXs in accordance with the ACA’s mandates
What we’re hearing from our clients indicates the majority want to make health
reform as state-specific as possible. In other words, they want to maintain control
over their HIX rather than defaulting to the federal solution. But as the certification
deadline looms, it’s increasingly important for states to consider a comprehensive
solution that doesn’t require building a product and allows time for customization.
We have formally announced our Health Insurance Exchange solution, which enables
us to provide a customizable HIX solution that states can tailor to meet the needs
of their residents and small businesses and be sure it’s ready on time. We were
recently awarded an ACA-compliant exchange in Nevada and also announced a partnership
with Florida Health Choices to build Florida’s insurance marketplace.
As federal rules regarding HIX development are still evolving, states have many
decisions to make around governing rules and scope, all while managing the very
complex, expanding, and resource-intensive Medicaid program, another huge impact
the ACA will have on states.
The expansion of the Medicaid program means more than 15 million new healthcare
consumers selecting and enrolling in a health plan, so states must be ready to
meet this new market and have a partner onboard with a strong portfolio of technology
and services to help them.
From a policy and programmatic standpoint, the process of administering this
influx of new beneficiaries is going to be complex. Obviously, state budgets will
continue to be challenged by the fiscal impact of these 15 million new consumers,
so states will look to technology vendors to provide efficient services and program
management services to help manage the cost of care. Having spent the last two
years in meetings with every state, Xerox is in a great position to help them
deliver these programs.
This decision is a landscape-shifting event and now more than ever, partnerships
are essential. It’s also a very exciting time because there’s been a bit of paralysis
in the market for the last two years, but we’re energized and also humbled by
the challenges ahead.
Will Saunders is the group president of government healthcare solutions for Xerox.
For more from Will Saunders, check out his interview discussing the Supreme Court
ruling on Xerox Blog Talk Radio.